Microscopic Colitis and Risk of Incident Psoriasis: A Nationwide Population-Based Matched Cohort Study

IF 3.4 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology Pub Date : 2024-03-29 DOI:10.2147/clep.s454677

David Bergman, Bjorn Roelstraete, Jiangwei Sun, Fahim Ebrahimi, Rickard Lidström, Axel Svedbom, Mona Ståhle, Jonas F Ludvigsson

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引用次数: 0

Abstract

Background: Microscopic colitis (MC) has been associated with several immune-mediated diseases including psoriasis, but earlier research has been limited to psoriasis occurring before MC. Data from large-scale cohort studies investigating MC and risk of future psoriasis are lacking.
Objective: To examine the association between MC and psoriasis.
Methods: In a nationwide, population-based, matched cohort study in Sweden from 2007 to 2021, we identified 8404 patients with biopsy-verified MC (diagnosed in 2007– 2017), 37,033 matched reference individuals, and 8381 siblings without MC. Information on MC was obtained through the ESPRESSO cohort (a Swedish histopathology database with nationwide coverage). Using Cox regression, we calculated hazard ratios (HRs) and 95% confidence intervals (CIs) for psoriasis up until 2021.
Results: During a median follow-up of 9.2 years (interquartile range = 6.7– 11.7), 179 MC patients and 440 reference individuals were diagnosed with psoriasis (241.1 vs 131.8 events per 100,000 person-years), corresponding to one extra case of psoriasis in 91 patients with MC over 10 years. After adjustment for the matching variables (birth year, sex, county of residence, and calendar period) and level of education, we computed an adjusted hazard ratio (aHR) of 1.82 (95% CI = 1.53– 2.17). Stratified by sex, estimates were similar and when examining the aHR across different lengths of follow-up, we found significantly elevated estimates up to 10 years after MC diagnosis. Compared to MC-free siblings, the aHR was 1.85 (95% CI = 1.36– 2.51).
Conclusion: Patients with MC are at an almost doubled risk of psoriasis compared to the general population. Clinicians need to consider psoriasis in MC patients with skin lesions.

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微小结肠炎与银屑病发病风险：一项基于全国人口的匹配队列研究

背景：显微镜下结肠炎（MC）与包括银屑病在内的多种免疫介导疾病相关，但早期研究仅限于 MC 之前发生的银屑病。目前还缺乏大规模队列研究的数据，这些研究调查了 MC 与未来患银屑病的风险：目的：研究 MC 与银屑病之间的关系：2007年至2021年，我们在瑞典进行了一项全国性、基于人群的匹配队列研究，确定了8404名经活检证实的MC患者（2007年至2017年确诊）、37033名匹配参照个体和8381名无MC的兄弟姐妹。有关 MC 的信息通过 ESPRESSO 队列（瑞典覆盖全国的组织病理学数据库）获得。我们使用考克斯回归法计算了2021年前银屑病的危险比（HRs）和95%置信区间（CIs）：在中位随访 9.2 年（四分位间范围 = 6.7-11.7）期间，179 名 MC 患者和 440 名参照个体被诊断为银屑病（每 10 万人年 241.1 例 vs 131.8 例），相当于 10 年间 91 名 MC 患者中多了一个银屑病病例。在对匹配变量（出生年份、性别、居住县和日历期）和教育水平进行调整后，我们计算出调整后的危险比（aHR）为 1.82（95% CI = 1.53-2.17）。按性别进行分层后，估计值相似，而在检查不同随访期的 aHR 时，我们发现 MC 诊断后 10 年内的估计值明显升高。与无 MC 的兄弟姐妹相比，aHR 为 1.85（95% CI = 1.36-2.51）：结论：与普通人群相比，MC 患者患银屑病的风险几乎翻倍。临床医生需要考虑有皮损的 MC 患者是否患有银屑病。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Epidemiology Medicine-Epidemiology

CiteScore

6.30

自引率

5.10%

发文量

169

审稿时长

16 weeks

期刊介绍： Clinical Epidemiology is an international, peer reviewed, open access journal. Clinical Epidemiology focuses on the application of epidemiological principles and questions relating to patients and clinical care in terms of prevention, diagnosis, prognosis, and treatment. Clinical Epidemiology welcomes papers covering these topics in form of original research and systematic reviews. Clinical Epidemiology has a special interest in international electronic medical patient records and other routine health care data, especially as applied to safety of medical interventions, clinical utility of diagnostic procedures, understanding short- and long-term clinical course of diseases, clinical epidemiological and biostatistical methods, and systematic reviews. When considering submission of a paper utilizing publicly-available data, authors should ensure that such studies add significantly to the body of knowledge and that they use appropriate validated methods for identifying health outcomes. The journal has launched special series describing existing data sources for clinical epidemiology, international health care systems and validation studies of algorithms based on databases and registries.